Objective: The purpose of the present study was to evaluate and compare the efficiency of two different protocols: MTA apexification and revascularization in treating patients with necrotic immature anterior teeth.Materials and Methods: Immature necrotic permanent anterior teeth (n = 24) of patients 7–16 years old were randomly divided into 2 groups according to the treatment protocol: group A (MTA Apexification), group B (regeneration). Follow-up was done up to 9 months. Standardized radiographs were digitally evaluated for an increase in root length, increase of root canal dentinal wall thickness, decrease in periapical radiolucency and decrease of apical diameter. An evaluation of the pain was also performed using the visual analogue scale (VAS) in each recall visit. Results: it was found that healing of the periapical disease has occurred in all cases. The statistical analysis of the results showed that there was no significant difference between the two tested groups in the root development.Conclusions: Revascularization had comparable, but not superior, clinical and radiographic outcomes with MTA apexification procedure.